The long-term cost of childhood conduct problems: Finnish Nationwide 1981 Birth Cohort Study

Background Commonly recognized childhood conduct problems often lead to costly problems in adulthood. This study aimed to evaluate the long-term cumulative cost of childhood conduct problems until the age of 30. The costs included inpatient care, nervous system medicine purchases, and criminal offences. Methods The study used population-based nationwide 1981 birth cohort data. Families and teachers assessed the conduct problems of the eight-year-olds based on Rutter questionnaires. We grouped 5,011 children into low-level of conduct problems (52%), intermediate-level of conduct problems (37%), and high-level of conduct problems (11%) groups, based on combined conduct symptoms scores. The analysis included the cohort data with the Care Register for Health Care, the Drug Prescription Register, and the Finnish Police Register. The cost valuation of service use applied national unit costs in 2016 prices. We used Wilcoxon rank-sum test to test the differences between groups and gender. Results During 1989-2011, average cumulative costs of the high-level (euro44,348, p < .001) and the intermediate-level (euro19,405, p < .001) of conduct problems groups were higher than the low-level of conduct problems group's (euro10,547) costs. In all three groups, the boys' costs were higher than girls' costs. Conclusions The costs associated with conduct problems in childhood are substantial, showing a clear need for cost-effective interventions. Implementation decisions of interventions benefit from long-term cost-effectiveness modelling studies. Costing studies, like this, provide cost and cost offset information for modelling studies

Successful desensitization with human insulin in a patient with an insulin allergy and hypersensitivity to protamine: a case report

<p>Abstract</p> <p>Introduction</p> <p>Insulin allergy may occur in patients treated with subcutaneous applications of insulin preparations. Besides additives in the insulin preparation such as protamine, cresol, and phenol, the insulin molecule itself may be the cause of the allergy. In the latter case, therapeutic options are rare.</p> <p>Case presentation</p> <p>A 68-year-old man with poorly controlled type 2 diabetes mellitus received different insulin preparations subcutaneously while on oral medication. Six to eight hours after each subcutaneous application, he developed pruritic plaques with a diameter of >15 cm at the injection sites that persisted for several days. Allergologic testing revealed positive reactions against every insulin preparation and against protamine. Investigation of serum samples demonstrated IgG antibodies against human and porcine insulin. We treated the patient with human insulin using an ultra-rush protocol beginning with 0.004 IU and a rapid augmentation in dose up to 5 IU. Therapy was accompanied by antihistamine therapy. Subsequent conversion to therapy with glargine insulin (6 IE twice daily) was well-tolerated.</p> <p>Conclusion</p> <p>As reported in this case, desensitization with subcutaneously administered human insulin using an ultra-rush protocol in patients with an insulin allergy may present an easy form of therapy that is successful within a few days.</p

Desempenho e hematologia de tilápias-do-nilo alimentadas com Saccharomyces cerevisiae e vacinadas contra Streptococcus agalactiae

O objetivo deste trabalho foi avaliar a inter-relação entre a suplementação alimentar com parede celular de Saccharomyces cerevisae e a vacinação contra Streptococcus agalactiae e seu efeito sobre o desempenho produtivo e as variáveis hematológicas de tilápia-do-nilo (Oreochromis niloticus). Oitenta e quatro tilápias-do-nilo foram distribuídas em 12 caixas de fibra (n=7), em arranjo fatorial 2x2x3, correspondente a dois níveis de suplementação com parede celular de levedura, dois tipos de inoculação e três tempos de avaliação. Os peixes foram alimentados durante 77 dias. A vacinação dos peixes foi realizada 60 dias após o início da alimentação. Quinze dias após a vacinação, todos os peixes foram submetidos ao desafio com cepa viva de S. agalactiae, e 6, 24 e 48 horas após o desafio, o sangue foi colhido da veia caudal para avaliações. Peixes alimentados com ração suplementada apresentam maior ganho de peso e taxa de crescimento específico, e a interação entre os efeitos da dieta e da vacinação resulta em maiores taxas de hematócrito, hemoglobina e leucócitos

Delamination buckling in composite plates: an analytical approach to predict delamination growth

An analytical modelling approach is presented which is capable of determining the post-buckling responses as well as the onset of delamination growth of multi-layered composite plates with an embedded circular delamination. In order to overcome current drawbacks of analytical models regarding embedded delaminations, the model employs a problem description in cylindrical coordinates and a novel geometric representation of delamination growth in conjunction with a Rayleigh-Ritz formulation and the so-called crack-tip element analysis. The modelling approach is applied to study the compressive response of composite plates with thin-film delaminations loaded under radial compressive strain. Post-buckling responses and the onset of delamination growth are determined for several layups. The results are in very good agreement with finite element simulations while requiring low computational cost

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Not AvailableBackground: Whirling disease (WD), caused by the myxozoan parasite Myxobolus cerebralis, is responsible for high mortalities in rainbow trout hatcheries and natural populations. To elucidate how resistant and susceptible rainbow trout strains respond to early invasion, a well-established model of WD was used to demonstrate the kinetics of local and systemic immune responses in two rainbow trout strains, the susceptible American Trout Lodge (TL) and the more resistant German Hofer strain (HO). Methods: Parasite load and cellular immune responses were compared across several time points after M. cerebralis exposure to elucidate the kinetics of immune cells in resistant and susceptible rainbow trout in response to early invasion. In the course of the 20 days following exposure, leukocyte kinetics was monitored by flow cytometry in the caudal fin (CF), head kidney (HK) and spleen (SP). For the analysis of the leukocyte composition, cells were stained using a set of monoclonal antibodies with known specificity for distinct subpopulations of rainbow trout leukocytes. Results: Experiments indicated general increases of CF, HK and SP myeloid cells, while decreases of B cells and T cells in the SP and HK were observed at several time points in the TL strain. On the other hand, in the HO strain, increases of T cells were dominant in CF, HK and SP at multiple time points. The differences between HO and TL were most distinct at 2, 4, 12 and 48 hours post-exposure (hpe) as well as at 4 days post-exposure (dpe), with the vast majority of innate immune response cells having higher values in the susceptible TL strain. Alteration of the leukocyte populations with augmented local cellular responses and excessive immune reactions likely lead to subsequent host tissue damage and supports parasite invasion and development in TL. Conclusions: The findings of this study highlight the significance of effective local and systemic immune reaction and indicate proper activation of T lymphocytes critical for host resistance during M. cerebralis infection. The present study provides insights into the cellular basis of protective immune responses against M. cerebralis and can help us to elucidate the mechanisms underlying the variation in resistance to WD.Not Availabl